When adults opt for medical treatment, they should be well informed of the expected benefits, expected pain and discomfort, possible risks and unwanted side effects, and the costs and consequences of alternatives such as no treatment or medication versus surgery (Ollendick and Prinz, 1993). In the case of psychotherapy, many therapists find it difficult to provide specific information regarding the length of the treatment, the nature of sessions, treatment plan, confidentiality, and its limits and alternative treatment options. However, mental health professionals are obligated to provide clients with such information that will enable them to make an informed choice regarding whether or not to pursue treatment. This is generally a time-consuming process. Concepts need to be explained in simple language (Ford, 2000).
Psychotherapy, while being beneficial and therapeutic, can also cause harm. Psychotherapy can involve transference reactions, regressive dependency states, and worsening clinical conditions (Simon, 2001). Therefore patients need to be informed of both the benefits and risks of specific psychotherapies. The following should be discussed with the prospective psychotherapy patient: anticipated benefits, potential risks, a cautious prognostic assessment, expected with and without treatment, and available alternative treatments, including risks and benefits (Simon, 2001). More specifically, Bruce Gross in his research paper titled “Informed Consent” emphasizes that it is against all professional ethics and all states’ law to treat persons without their informed consent.
Legally, consent requires the existence of three conditions: the consenting adult must be mentally competent, the consent must be given voluntarily and it must be informed. For consent to be informed, the potential client must fully understand what they are consenting to. In particular, all clients should be provided with specific information to include: the professional’s title and license, training, and experience in brief, as well as any issues or personal problems that can negatively impact the treatment process; the limits of confidentiality; details of records that will be made and maintained; diagnostic and treatment methods that might be used; availability of the professional in the event of a crisis; anticipated length of treatment; fees and billing practices; alternative treatment options; expected benefits of treatment; possible risks of treatment; and the rights of all clients including the right to not pursue treatment at all or with the given professional (Gross, 2001).
Informed consent is sometimes obtained orally in the first session. But in the case of psychotherapy, the amount of information to be provided is voluminous, and clients are likely to be in an emotionally heightened state. To counter these issues, some therapists elect to send a consent letter to new clients prior to the first session. Other therapists create a standard form that is reviewed with a new client during the first session. The form is signed and dated by the client and well documented. Without such documented consent, the mental health professional is at risk of having his license suspended or revoked.
Bibliography
Ford, George Gary (2000). Ethical Reasoning in the Mental Health. CRC Press. 2000.
Gross, Bruce (2001). Informed Consent. Annals of the American Psychotherapy Association. Volume: 4. Issue: 5. 2001. Page Number: 24.
Ollendick, H. Thomas and Prinz, J. Ronald (1993). Advances in Clinical Child Psychology. Springer Publications. 1993.
Simon, I. Robert (2001). Concise Guide to Psychiatry and Law for Clinicians. American Psychiatric Pub., Inc. 2001.
It seems natural that teenagers sometimes feel unhappy. This statement is especially understandable if we take into consideration the fact that the organism of the young adult is experiencing the hormonal changes. The frequent changes of mood are typical for the adolescence. However, according to recent findings eight out of ten teenagers suffer from depression.
Although depression is the problem that can be cured, it is worth noting that it should be diagnosed first. The teenagers are the vulnerable group as they experience a difficult transition of the maturing process. Thus, the symptoms can be hidden, and depression can be confused with a bad mood. What are the outcomes of depression? Can it spread between the adolescence? Is it contagious? These types of questions were the main concern of a number of researchers. The primary purpose of this paper is to investigate whether depression spreads over teenagers.
To get deeper involved in the issue, the reasons for depression in adolescence should be identified. As a matter of fact, there are many reasons why a teenager can feel unhappy. First and foremost, a bad grade can influence the adolescence significantly. A teenager can feel worthless. School performance, social status among peers, sexual orientation, relationships within the family, these are the factors that have a huge impact on the mental state of a teenager. However, it should be noted that if neither friends nor relatives nor even hobbies can help a teenager to get rid of feelings of depression, regardless of its causes, there is a huge possibility that this adolescence has depression.
It is of paramount importance to know the symptoms of depression in order to be able to deal with it. In the majority of cases, the symptoms of depression in teenagers manifest in mood and behavior changes. Sick children lose motivation in life and become withdrawn; coming home from school they close their room and can sit alone for hours (Mufson 81). Depressed children usually experience drowsiness, appetite swings, and even criminal behavior, such as petty theft in stores or alcohol and drug intoxication. Below are the main symptoms of the adolescent depression:
Apathy;
Persistent pain, such as headaches, stomach pain, back pain, and fatigue;
It is difficult for a teenager to focus and concentrate;
It is complicated for a teen to make own decisions and choices;
The irresponsible behavior is very common. It is usually reflected in forgetting the duties; the teenager is late for school or even skips it;
Loss of appetite or over-eating is another symptom, which leads to significant weight loss or overweight. Thus, depression can consequently lead to a number of additional health-related issues;
Forgetfulness;
Obsession with thoughts of death;
Rebellious behavior;
The feeling of sadness, anxiety, or hopelessness;
Insomnia at night and increased drowsiness during the day;
The sudden decline in school performance;
The use of alcohol, drugs, and casual sexual relationships;
Avoiding friends (Mejia 19).
The above states symptoms are essential to be taken into consideration as depression can lead to a number of problems or even suicide. In order to eliminate severe consequences, the families should pay enough attention to their children. The experts in the field of depression state that it can be hereditary. In case somebody in the family experienced depression aged 15 to 30, there are a lot of chances that a child will face depression as well (Mufson 94).
It should be highlighted that in spite of the fact the technological progress stimulated rapid development and improvement of the medicine, it is essential to make an accent that there are no specific medical tests, with the help of which one could say that the adolescent has depression. A psychiatrist diagnoses the teenager with depression, referring to the results of interviews and psychological tests with the teen, his family, teachers, and friends.
The stage of the disease and the risk of suicide are commonly determined on the basis of a detailed assessment of these interviews. According to the information obtained through interviews and psychological tests, the professional offers appropriate methods of treatment. The psychiatrist will also consider other mental disorders, such as anxiety, schizophrenia or abusive behavior. The expert will also examine in details whether the child is capable of murder or suicide.
It seems important to empathize that the suicidal behavior can be noticed, and instant reaction will help a teenager and possibly can save his or her life. Suicidal behavior among teenagers with depression is a crucial problem. According to the statistics, the teenage suicide is the primary reason for a death of adolescents in the United States. Recent findings revealed an impressive statistics; over 500,000 of teenagers had an attempt to commit a suicide and almost 5,000 of individuals succeeded in their attempt (Elliott 52).
What are the reasons the youth are ready to end their life? Problems in the family, loss of a loved one, failure at school, or persistent failure in personal relationships, every factor from the stated above can because negative thoughts, lead to depression, and result in death. For a teenager, these problems seem insurmountable, and the pain they cause is believed to be intolerable. Suicide can be considered as an act of desperation, and the main reason for it lies in adolescent depression. A number of lives could be saved if the symptoms of depression were noticed. A teenager cannot get rid of depression on his own, and thus, needs help and support.
With the consideration of the statistics that is presented above, a question arises whether depression is contagious and is there a threat that one depressed teenager can stimulate the development of depression in the group? Hearing the word depression, the majority of people think of neurotic reaction, which developed as a reaction to stress. Depression is a disease, and the person cannot deal with it on his own, and thus, in order to cure it, the help of the professional is essential. Fortunately, depression is not a common phenomenon as the majority of people tend to confuse depression with fatigue, stress, and temporary emotional discomfort. Depressive disorders often occur because of stress.
Every person reacts to situations differently, depending on the type of nervous system, temperament, and the perception of the world. Perhaps a lot of people have already noticed that communicating with the pessimistic person or the one in a bad mood it is easy to succumb to melancholy and experience almost the same feelings that the partner does (Jones par. 5). This fact is commonly examined in psychology as people tend to adjust to other people and experience close emotional connection. However, despite the fact that people can be influenced by the mood of the communicator, it is worth highlighting that depression cannot be acquired from the communication with a depressed person. Nevertheless, it can lead to pessimistic thoughts, bad mood; however, it is not enough for the depression to develop.
The researchers of the University of Warwick in the United Kingdom decided to investigate the relation between the spread of depression and happiness among the teenagers in the United States. The experts analyzed the mood of students that study in over than 2,000 different schools across the United States. The conclusion that was drawn by the researchers positively shocked the public as the scientists proved that depression is not contagious, whereas happiness is. Frances Griffiths, the head of Warwick Medical School, states that:
Depression is a major public health concern worldwide. But the good news is we’ve found that a healthy mood amongst friends is linked with a significantly reduced risk of developing, and increased chance of recovering from, depression (Dockrill par. 1).
The contagion model helped the researchers to make appropriate conclusions. The students were classified into two groups, namely the ones that have symptoms of depression, and the ones who do not. The outcome of the experiment is significant for the development of new methods that will combat the depression of adolescents. Happy and healthy friends will not only eliminate the risks of depression, however, will also contribute to the recovery process in case a teen experienced depression.
Edward Hill, the scientist that investigated the relationships between depression and happiness, notes that “our results suggest that promotion of any friendship between adolescents can reduce depression since having depressed friends does not put them at risk, but having healthy friends is both protective and curative” (Dockrill par. 4). As a result, friendship is significant not only for entertainment and support; it can also cure (Feller par. 5). Teenagers are highly dependent on friends and problems with peers can be felt like a personal tragedy. Deep listening and communication with a teen can positively influence his self-esteem and eliminate the risk of depression as teenagers are vulnerable in terms of public opinion (Jones par. 3).
In conclusion, it is worth highlighting that recent researches proved that depression cannot be transferred to a friend during communication. Happiness is the guiding power that can influence everyone. This outcome of the research conducted by a group of scientists from the United Kingdom makes a valuable contribution to the development of treatment for the depression. Depression of teenagers is a global problem that the society should deal with.
Stress and the feelings of worthlessness may consequently lead to depression and result in suicide. In order to eliminate the lethal outcomes, families and teachers should pay attention to the teenagers and be ready to react appropriately in case the symptoms are noticed. As a matter of fact, advertence can save lives of thousands of teenagers who have suicidal thoughts. The problems that the adolescents experience seems unsolved and can be perceived as tragedy, however, it is not so. The hormonal changes impact the mood and behavior of a teen, and thus, they need help and support to overcome difficulties. Human life is the biggest value, and the society should protect the generation of teenagers from the mistakes that can result in a lethal outcome.
Yalom is a professor of psychiatry at the University of Stanford. He is the author of numerous highly appreciated textbooks, which include The Theory and Practice of Group psychotherapy and Essential Psychotherapy.
He also wrote several novels and stories related to psychotherapy. Some good examples are Nietzsche Wept, love’s Executioner, Momma and the Meaning of Life, Lying on The Couch and The Schopenhauer Cure. His most recent non-fiction work is Staring at the Sun: Overcoming the Terror of Death (Barlow & Burlingame, 2006).
His Theory and Practice of Group Psychotherapy
Yalom is a paramount theorist of group psychotherapy. One should take his works seriously as he truly deserves it. His bulky tone is rightly regarded as one of the necessary treaties in the field of psychotherapy. It has similarities with Yalom’s other works about existential psychotherapy.
Despite this factor, it is very difficult to detect the connection between his curiosities in these two different fields. The basic aim of Yalom is to analyze the making-up of group dynamics. He scrutinizes the entire group life cycle, beginning from its formation until its break up.
He is greatly concerned with the group leaders’ function, nature, and his role in the group (Bion, 1991). He discusses different ways through which groups go astray. Yalom came up with four theories. These are interpersonal theory, psychodynamic theory, system theory and action oriented theory. All the things he puts across are interesting and provide useful information.
Interpersonal theory
According to Yalom, a child perceives the environment and acts in the environment in a way that can enable him or her to develop strong connectivity and acceptance mostly by the parents. During the early years, behavior develops during this particular period. This is the main basic feature of personality (Bion, 1991).
Interpersonal view is greatly compatible with group psychotherapy. This is because problems can be solved through observation of their group members. The members have the opportunity to observe each others’ points of view on life issues. This will provide a great chance for one to learn how others feel about him or her. This is because the group traditions encourage the members to talk about their points of view on specific matters.
Therefore, it enables one to get the chance to express personal thoughts with minimum fear. Yalom takes the group in form of a microsom or a little world (Barlow & Burlingame, 2006). He believes that everybody will try to manifest their interpersonal styles whenever they move to.
In this case, the person will have to learn different aspects of life in a way that gives a chance to interact with a variety of personalities. The interpersonal group therapy works from this perspective. Those responses that bring many difficulties will have to cause alternative despondences from another group. This will help members of different groups experience life in a more diversified manner than being in one area without any person to intermingle.
Psychodynamic theory
This type of theory is highly compatible with interpersonal theory. Within a group of people, there are many other theoretical approaches. Examples include ego psychology, self-psychology together with object relation theory. It is from Yalom’s perspective that personality development comes from psychodynamic perspective through different stages. He observes that there exist tasks and conflicts within each stage (Yalom, 2005).
It depends on how the child addresses the issues that contribute to the personality development during adult stage. Psychodynamic looks at personality as processes and features that one can access consciously and that reside out of conscious awareness (Yalom, 2005).
Psychodynamic proves that during the growth period individuals develop defense mechanism to keep out of psychological contents like fantasies, affects and impulses that are quite intolerable to them. The psychodynamic therapist takes advantage of the situation to utilize his or her skills. This is because a group will provide the best medium like individuals and the group proceed through different stages of development.
Systems theory
According to Yalom, a group is a type of force that resides within a space in life or environment. It is from his point that as the group moves towards the intended goals, the forces found inside and outside of the group, its goals and other forces, pull the group against attaining its objectives. For example, when a group of inpatients discussion is cut short by an alarm that alerts people of the broken fire, this prevents them from achieving their objectives.
This is taken as a restraining factor in the progress of the group since the therapist will have to stop and try to observe the safety of the patients together with his/her own life (Bion, 1991). On the other hand, when the team of therapists arrive at the discussion place at the required time, this can act as a driving force to the group members leading them to continue with the sessions until the end of the discussion. For a group to archive its goals, it greatly depends on the restraining and driving forces.
In this context, each group member is also another force in the group (Yalom, 2005). It is possible that each group member has his/her goals. The goals are exposed to restraining and driving forces towards attaining or failure in attaining the goals. He puts across that a group is a form of system and individuals form subsystems.
Therefore, in this context, the systems according to hierarchy, are related and that there are no boundaries between subsystems and systems. They are porous and they allow sharing of information. For example, if an outpatient has a distinctive form of authority, then the authority can get into the system of the health institution.
Action oriented theory
Action-oriented theory has its base on physical activities where members of the group plan on how to dramatize their own experiences in life. In this context, the other entire member is able to experience the same form of life (Bion, 1991). This is a powerful tool since it gives all the group members the chance to socialize and give different kinds of experiences thus enriching themselves.
The psychodramatic is a form of role, which is an individual’s way to relate with others. For instance, if a female person who suffered from emotional anxiety can give part of action to let his/her group members realize the effects on the person’s personality development. The group members can offer assistance to help guide others who may undergo the same problem in future.
Conclusion
Yalom wrote this wonderful book for both psychiatrists who are in the field and those who will come later. He consciously notes several considerations that the clinicians have to put in mind when they are forming a group and then how to lead this particular group. He also provides important information to the clinicians who have been in the field with great ideas that help them sharpen and improve their skills (Barlow & Burlingame, 2006).
He incorporated most of his own experiences with people in different groups. This makes it very interesting in the fact that it may look like a storybook. He highlights important issues in today’s life beginning with therapy then revealing much more in the contemporary world. The most important part of his work deals with treatment models and diagnostic methods for managing care in the health institutions which most of the writers have never dealt with.
References
Barlow, S. & Burlingame, G. (2006). Essential Theory, Processes, and Procedures for Successful Group Psychotherapy: Group Cohesion as Exemplar. Washington DC, McGraw-Hill.
Bion, W. (1991). Experiences in Groups; and other papers. New York, NY: Routledge.
Yalom, I. (2005). Theory and Practice of Group Psychotherapy. New York, NY: Basic Books.
The client decided to seek professional help because she was suffering from a mental disorder. June, a 26-year-old African American lady, reported having cases of self-injury. The proof of the disorder had manifested on her thighs and biceps accompanied by the two suicidal attempts. The first case was reported when she was an adolescent after trying to overdose. She used the same technique six months ago in the second case. The patient was described to have chronic suicidal ideation, which would act as a relief to her.
Symptoms and Reasons for Referral
The symptoms were the main reason why she opted for professional help. The signs comprised the anger she felt against her partner despite being in a healthy romantic relationship (Şavk, 2022). The anxiety manifested as she thought of how her partner would leave her because of the habits she portrayed. The two suicidal attempts fall in the same category as they could be used as a confluence for seeking professional assistance. The different moods she experienced with her partner signify that she had emotional dysregulation.
June was not satisfied even after the engagement with her partner. Impulsivity manifests through her actions, making it necessary to ask for help. The mood cycles that made her change hobbies, attire, and job could be identified as a symptom requiring attention. Throwing objects at her partner and overdosing twice showed she engaged in risky behaviors which would require further attention. The cuts on her arms and legs were assurance that she needed a therapy session. Suicidal ideation shows she required immediate care and a way out of the situation she could have been going through.
Objects Relation Theory
According to Jalali (2018), the objects relation theory is less concerned with one’s biological features as it stresses more on interpersonal relationships. The object theory could be observed in a situation where one would show a mother’s intimacy and nurturing. The idea primarily focuses on the need to establish relationships and contact. The view does not focus on sexual pleasure as the pre June focus. The two aspects manifesting within the theory are personality development and factors that motivate human habits. The term object, in object theory, could be viewed as a reference to a significant person who would influence a relationship. The persons would involve a priJune caregiver, father, or mother.
There would be instances where the word would be used to reference parts of an individual whose interaction would create a particular type of relationship. The details include a mother’s breast or a mental representation of the significant other. The theory explains how humans are influenced by the need to make contact. Object theory was derived from the psychoanalytic theory, giving it a base that could be referenced when catering to biologically related issues. The psychoanalytic theory manifested from a divergence from Sigmund’s belief of how humans are motivated gave birth to the object theory (Jalali, 2018). The difference between the two beliefs was that Freud focuses on aggressive and sexual drives while the other dwells on the need for contact.
Theoretical Case Conceptualization
June’s case aligns with the theory of the object because her condition shows her relationships influenced her. Notably, she could change her hobbies, job, and clothing depending on the person in her social group. June appears to lack a sense of self-awareness because other people, including her peers, easily influence her (Şavk, 2022). The influence is alarming because it shows she could go extra to give up a job just to fit within her social circle. June is attached to the objects her peers work with, motivating her to change her attire to be accepted. A change in hobbies indicated that she had reached a level where she could not find happiness alone. Recreation such as surfing could be simple, which one would not quit relating better with their friends. Individuals would be expected to be themselves among their friends without fear of expression.
A change in how one dresses shows discomfort in their previous style. June shows she would be uncomfortable hanging out with a group that is not used to her dress code. Her decision to change her attire to match her friends shows she would be willing to sacrifice her comfort for contact. The object theory is evident in her relationship because she regrets her behavior towards her partner, thinking he would leave her. The context shows that she clams down because she feels she would be overreacting, making her man uncomfortable, and abandoning the relationship. The fear of being left was the motivation for the habits she portrayed, proving that the need for contact could shadow sexual attraction.
June indicated that stress makes her less attentive and causes her to lose herself. The incident happens during an interaction or even at work, making the issues unpredictable. June reported that people could influence her to change her lifestyle based on their experiences. June could vary her hobbies, work, and clothing depending on the people in her environment. Moreover, she admires her partner and expresses it to him by sending lavish gifts and adorable texts. The thought of having him makes her think he is the best thing she has ever experienced in her life. There are others when she thinks of attacking him because she can no longer bear his presence. June would lash or ignore him, followed by throwing objects and yelling. Alternatively, she regrets everything after concluding her partner would leave her because of her behavior.
Transference and Countertransference Issues
One of the transference issues that would be present during the session would be idealization (Jenks & Oka, 2021). June would think the therapist is better than her, which could have psychological effects. The tension could make her leave out important questions believing her service provider would be correct at all times. The following issues would issue would be a comparison between the two. June would make a mistake if she were to compare herself to the other lady disregarding her professional skills. The problem would be assuming that all women may be going through the issues with their partners and omitting data that would be obvious to her. The session would experience opposition from June, believing that the therapist would be unable to figure out her problem because she lacked understanding.
Countertransference issues could emerge during the interaction as time passes. June could develop anger issues from the fights with her partner and manifest them during the session. Additionally, she would be easily distracted by how the therapist would have dressed because she is keen on such details. She might go further and try to dress as the therapist to make herself more compatible with the program. The event could be driven by her need to be understood better because dressing similar could reference she could use her fashion sense to understand her problem. June would be attracted to the therapist because they would be offering solutions to their disorder which could register as caring. The need to strengthen the relationship would lead to misconduct or sharing more information than needed.
Multicultural Issues
Racism contributes to June’s situation because she is a black woman. There is a likelihood that she changed her clothing to show she could be like others. An attire communicates specific ideas such as religion, occupation, and exposure (Davis et al., 2018). June indicated she would change her dress code based on her social circle indicating she wanted to fit within a particular culture. Her hobbies should not have changed regardless of the people she interacted with, as she could influence them too. Religion should be viewed as a vital aspect of one’s life because it would create psychological problems for people as they grow and move to different locations.
The case would have involved Muslim friends whose attire is dictated by their religion. June changing her clothing to fit their activities would mean she would be new to their design and turn to be uncomfortable. June may be trying too hard to ensure she would not be marginalized. The effects of such an effort would lead to mental disorders arising from the stress of keeping up. The skin color puts June at a disadvantage because she might assume her different style would make her receive further treatment from her friends. June should uniquely express herself that she enjoys and feels proud rather than trying to keep up with every social circle she experiences.
Jalali, F. (2018). Comparison of relationship theory from perspective of Freud and Klein in Ian McEwan’s works. Journal of Applied Linguistics and Language Research, 5(5), 153-160.
Şavk, C. (2022). Investigating the role of family-of-origin risk factors in the prediction of current intimate partner violence: Testing a proposed model based on object relations theory (Doctoral dissertation, The Department of Psychology). Ted University.
Behavior therapy aims at assisting individuals to understand the effects of their actions on feelings and expectations. For the case of Stan, he has to be encouraged to interact with other people in a positive way in order to eliminate idleness and the sense of inferiority. Behavior therapy suggests that any social problem could be interpreted from two levels that are, the micro-level and the macro-level analysis. For Stan, the problems facing him are caused by societal problems, such as lack of housing, inadequate shelter, low income, unemployment, continued imprisonment, health problems, inadequate education, and issues related to identity, including inferiority complex. These issues can be resolved using the behavior therapy model, as his condition is purely sociological and only sociological solutions are needed to salvage the situation.
The model notes that healthcare professionals, such as psychologists, have the power to influence the views of the individuals whereby the main aim would be to enhance identity and connections. Stan feels rejected when he is told that he cannot be employed because of his diminutive education and lack of experience in the corporate sector. The model argues that issues facing an individual, such as Stan, at old age could be the result of a troubled childhood. Based on this, the major role of any counselor is to strike a state of balance in the life of Stan, which might have been affected by the long-time unemployment and sense of guilt. While solving the issue, the therapist ought to involve the entire family, as they are also affected by Stan’s situation. This will ensure that the issue is resolved both at an individual and family level. Once a state of balance is achieved, the therapist should start addressing the problems facing Stan, as this is considered an optimal goal.
Many people in modern society are likely to encounter certain types of thoughts and feelings that are likely to reinforce or fault their cultural beliefs. If care is not taken, an individual’s beliefs could affect the behavior, leading to problematic relationships, failures in workplaces, and collapsed families. Stan is one of those who face the risk of losing contact with his family, as well as friends, as he is concerned much about providing the basic needs for the extended family, yet he does not have the means. Currently, he suffers from low self-esteem, which might result in negative thinking, as well as a negative perception of society and everything in it, including his ability to perform some of the core duties. In this case, it is suggested that the patient has started avoiding core responsibilities. This is one sign of the patient suffering from depression and the use of the model is the best in resolving the issue. The first step for the therapist would be to help the client identify the problematic belief that has been disturbing him for some time (Corey, 2013). The stage is popularly referred to as functional analysis, which is an important stage in studying the thoughts, beliefs, and feelings of an individual.
Through the model, the therapist should recommend some practices and exercises to Stan, as they will help him cope with the situation. The first step towards full recovery from the problem is self-evaluation. In fact, it is the first stage of treatment whereby Stan would be asked to keep a record of all daily activities. The therapist will then examine the list in the next session to determine what could be wrong with his life. The second step is scheduling weekly activities, which is important in providing an opportunity for the patient to experience something different. Role-playing is the third stage and it would help Stan to develop critical personal skills. In case a new challenge emerges, Stan would invoke the life skills in facing them. Finally, the patient is encouraged to modify his behavior and a reward should be given upon successful modification.
Cognitive Behavior Theory
Social roles can sometimes put too much pressure on an individual to an extent that he or she feels stressed. In the case provided, Stan faces several challenges regarding the accomplishment of the family tasks, something that affects his character. He has a feeling that he must provide for the basic needs of the family, yet he is jobless. Life becomes difficult when Stan is sacked from his long-serving job, having worked for quite some time. This affects his personality, as he refuses to accept the reality that the family can still exist without his salary. Through the cognitive behavior model, it is noted that Stan does not have a clear understanding of his thoughts and feelings. Cognitive behavior therapy is a model that psychologists employ frequently to treat a number of disorders, such as irrational fear, compulsion, despair, and nervousness. The major concern Stan is how to provide for his family and the siblings. The model is utilized because it is effective in solving short-term problems. However, it does not have the power to offer a lasting solution. The major aim of the therapist would be to identify and change his views or the most worrying pattern of thought, which affects the normal functioning of Stan. A close analysis of his behavior, through the cognitive behavior therapy model, suggests that certain feelings and thoughts have a critical role to play in the life of an individual (Corey, 2013). For Stan, he has to come to the reality that things cannot happen the way he wants, but instead he has to interpret an event or situation from a different perspective if he is to survive in the highly unpredictable society.
Reality Therapy
Reality therapy is closely related to the choice theory and its major aim is to connect an individual to the entire world. An analysis of Stan’s life reveals that he operates in isolation because he feels he does not have enough skills to interact with people around him in the workplace. Therefore, he has to be encouraged to concentrate on developing his future and avoid reflecting on past events, as only current problems affect relationships (Corey, 2013). Since he complains of being ineffective and valueless in society, the therapist has to keep off from discussing the symptoms and his weakness. The counselor has to act and think professionally meaning that he or she has to spend little time on issues that cannot be resolved instantly and try as much as possible to change his feelings. Throughout the discussion, the therapist has to be supportive and tolerant to give him time to narrate the story, as any information would be important in arriving at the conclusion.
Reference
Corey, G. (2013). Theory and practice of counseling and psychotherapy (9th ed.). Belmont: Wadsworth.
Psychology is a branch of science in which there is studying of behavior and mental processes. It can also be defined as the study of the mind and behavior of human beings. It is the application of knowledge in the study of human activity such as the day to day lives and mental illness. Psychotherapy on the other hand can be defined as the treatment of patients by influencing their mental life. It differs from psychiatry in that; the former is the treatment of mental illness while psychiatry is the treatment of mental diseases. Of course to a certain extent, mental illness too, is open to mental treatment; but definitely many diseases of the mind lie exclusively beyond the reach of psychotherapy. The treatment of mental illnesses by influencing the mind has been in existence for quite along time, but it has attained at various times very different degrees of importance. This paper will look at psychoanalytic theory as a method of treatment of mental illness; it will also give a brief history of how the theory came into being, explain some of the criticism that have been attributed to the theory and conclude by giving its application.
History of Psychoanalytic Theory
The theory of psychoanalytic was first developed by Sigmund Freud. He is one of the ancient psychologists. He was born in 1856 (in Freiberg). His family was full of confusion and complexity which inspired him to study the individual mind. His mother was the third wife. In 1900, his father died. This was the time he had involved himself in intense work and was inspired to publish the books called The Interpretation of Dream and Psychopathology of Everyday life (Eysenck, 1994). Freud is often referred to as the father of psychology because of his research in the area of psychology. He carried out researches to study people’s thought concerning the world and themselves. The aim of his research was to “agitate the sleep of mankind”. He was successful in his research and founded a new field of psychology and managed to create a new individual’s scientific conception.
Freud developed a theory describing the organization and internal operations of human minds. This theory was called the psychoanalysis. The aim of this theory was to study the psychological functioning of human beings and their behavior. Three applications are used in this theory (i.e. investigation of the human mind and thoughts, study of human behavior, and treatment of emotional illness). Fraud established clinical procedures that would be used to treat mentally ill persons. According to him, individual personality is developed from childhood experiences. The aim of this therapy was to convey reserved thoughts and mind-set into consciousness in order to free the patient from suffering recurring fuzzy emotions. These reserved thoughts and feelings are brought to consciousness by encouraging a conversation between the doctor and the patient. Patients are encouraged to talk freely and express their dreams and experiences (LaBerge, Kahan, & Levitan, 1995).
Description of Psychoanalytic Theory
According to Freud, psychoanalysis is a procedure used to treat the medically ill individuals. He called it “The doctor’s ‘treatment’ and it involves eliciting repressed memories from the patient by interpreting the responses to his questions” (Asiado, 2007). He observed that a psychologically ill individual would be encouraged to re-live (previous) experience and this would be employed as a mode of treatment.
Psychoanalysis is a direct involvement between the analyst and the patient. This practice aids patients to find out and determine reserved conflicts (principally the early-childhood conflicts with the close relatives). In the psyche, “the interpretation of Dreams”, Freud proposes that dreams could be employed in demonstrating the judgment of the ‘unconscious mind’. He described dreams as the noble road to the unconscious. In the unconscious mind painful memories are repressed but can be accessed through psychoanalysis treatment. In the course of being awake, there is deriving of this model basically from the sensory input. The secondary input offers the information that is most current about the conditions that are prevailing presently and the secondary basis from information that is motivational and contextual. At the time one is asleep, there is very minimal (sensory) input. Consequently, the dreams that people have are under the determination of their fears, their hopes, and their expectations. From this stand point, dreaming can be taken to be a unique case of perception (LaBerge, Kahan, & Levitan, 1995). On the other hand, perception can be viewed as the case that is extraordinary of dreaming under the restraints of (sensory) input. From either way a person may view this, having an understanding of dreaming is core to having the understanding of consciousness.
The theory involves intervention such as confronting and illuminating the patient’s pathological suspicions, desires and guilt. Through analysis of individual’s conflicts, psychoanalysis treatment can be used to prove that patients’ unconsciousness is the worst threat of causing symptoms. Fraud’s theory can be split into five major parts i.e. economic, developmental among others.
The dynamic part of the conjecture concerns the patient’s (instinctual) forces. Fraud confirmed that, a patient’s instincts can be grouped into two major instincts that is the Eros or sexual instinct and the antagonistic instinct. Although these instincts work together, in some instances, they work against each other.
Criticisms of the Theory
The study of psychology is subjective rather than objective and can not always be relied upon for the prediction of human behavior. For example it becomes had to define a disorder and to distinguish some one who has it from one who does not. The validity of Freud’s procedure is questionable and has been criticized by other psychologist and scientists. The doctor’s treatment as defined by Freud seems to be strange because the doctor and the patient hold conversations only with nothing passing between them. Moreover, the doctor’s interpretation is not objective or testable. However, Freud’s treatment has been popular and has some logic in it. For example he observed that individual personality is understood by interpreting a description of childhood experiences (Asiado 2007). There have been claims that such interpretation has some truth about the patient. Claims has also been put forward that both the interpretation and the conversation processes can be employed in the effective management of nervous ailments.
Another common criticism in psychoanalytic is the criticisms of artificiality. This refers to the state of imitation or lack of naturalness in the human behavior. It can be defined as the state of making judgment without taking into consideration the needs of a particular situation or person. There is an inconsistency between internal and external validity of research in psychology. Internal validity refers to the ability of making casual conclusions after carrying out a research. In most cases these results are replicable and vigorous. On the other hand, external validity refers to the likelihood of oversimplify conclusion based on the situation that incited the research. Ortmann & Hertwig (2002) observed that, in psychology, research is based more on the internal validity and less on the external validity. This is not the case in field experiments where a position is held between the two findings. However, they also noticed that there has been an increase in the recognition of field experiments which has created an interest in the external validity of laboratory experiments. A major obstacle to the external validity of an experiment is the artificiality of the setting. If the laboratory institutions and incentives do not sufficiently mirror those outside-the- laboratory situation they intend to study, the loss of external validity may be significant.
The criticisms of artificiality can be applied in other sub disciplines of psychology such as abnormal psychology, social psychology and organizational psychology. Abnormal psychology is based on arguments against specific applications that do not reflect any objection to human experiments. Artificiality affects such findings and does not give a clear picture of the human behavior. Social psychology is affected in that, a lot of imitation affects human’s social life because of demise of their originality. Lack of naturalness and originality affects the organizational structures not only in the work place but also in the community.
Other professionals criticized the theory as being too simple to explain the complexity in the human mind. They argue that, the human mind is too complex to be understood by just the use pf psychoanalysis. However, this criticism is not true because psychoanalytic theories of personality have proven to be strongly heuristic. Thousands of studies have either tested some psychoanalytic suggestions or have extended psychoanalytic theory into new areas. It is probable that, psychoanalytic theory has motivated more research than any other theory of personality. If one decisive factor of the advantage of the theory is heuristic, then psychoanalytic theory has more than pleased this test. Moreover, converse to the view of many critics, a significant number of psychoanalytic proposals have been found to be constant with experimental results. There is much more scientific worth in psychoanalytic theories of personality than critics have approved (Suite, et al 2007).
Practical Application
Talking about dream interpretation and symbolism, dreams may serve as very strong sources of information that can change one’s life if close attention is paid to the meanings which these dreams have. The interpretation of dreams as well as analyzing the symbols of dreams gives out some clues in regard to a person’s life that could never be seen otherwise. The interpretation of dreams calls for an intuition that is well developed in order to get clearly the meanings of these dreams and carry out the analysis of those messages that are hidden in these dreams (Hook, 1990). This is for the reason that the dreams are just the same way as individual as human beings themselves.
To investigate the epistemological base of the psychoanalytic theory of dreams entails that we first spell out some concepts that are basic to this issue. These basic concepts include justification, meaning and truth. First, concerning justification, we must understand exactly what comprise an adequate for justification to the psychoanalytic theory and what forms of justification have been applied in the course of the development of psychoanalysis. Similar to the concept of justification, the notion of meaning must be distinguished. For the application of Freud dream analysis to be effective, one has to understand what is meant by “meaning” and what Freud meant. There are diverse forms of explanation and many meanings to meaning within psychoanalysis (Hook, 1990).
It would be a blunder to consider psychoanalysis as an amalgamated discipline. Psychoanalysis is better considered as a group of unified ideas, theories, and observations that interrelate in multifaceted ways. The extensive assortment of depiction of human psychological life, the classifying of those remarks and their simplification are called the clinical theory of psychoanalysis (Suite, et al 2007). They explain how people mind function psychologically, in a manner close to normal experience and use language close to common speech. In the scrutiny of many psychoanalysts, clinical theory comprises the major contribution of the field. The major hullabaloos within psychoanalysis have concerned the emphasis that should be given to each of the various viewpoints that come out from the close study of the productions of patients in analysis rather than whether or not any of them is outstanding, for example Freud analysts concentrate more to the emotional struggles that consequence from the young child’s wish for erotic enjoyment and the doubts linked with that wish. On the other hand, self psychologists center their attention on the experience of a consistent and dynamic self and the intimidation to that experience.
Conclusion
Psychotherapy can be defined as the treatment that is used to cure people suffering from mental illness. One example of psychotherapy treatment is psychoanalysis theory. The treatment of mental illnesses by influencing the mind has been in existence for quite along time, but it has attained at various times very different degrees of importance. It is a direct involvement between the analyst and the patient. This procedure assists the sick individuals in establishing and resolving reserved conflicts particularly the early-childhood conflicts that occur between children and their guardians. This theory was developed by Freud after the death of his father. He was brought up in a confused family which inspired him to study the human mind and behavior. According to him, dreams interpretation can be used to treat mental illnesses. He observed that dreams can be used to demonstrate the judgment of the unconscious mind. He described dreams as the noble road to the unconscious. In the unconscious mind painful memories are repressed but can be accessed through psychoanalysis treatment.
Psychoanalysis has been criticized by other psychologists and scientist for its luck of validity. They argue that the human mind is so complex that it cannot be understood by a mere psychoanalysis. They also argue that, Freud model consider conversations between the doctor and the patient without anything passing between which is not efficient in treating mental illness.
Reference List
Asiado, T. (2007). Sigmund Freud and His Couch.
Eysenck, M. W. (1994). Perspectives on psychology, principles of psychology. Philadelphia: Psychology Press.
Hook, S. (1990). Psychoanalysis, scientific method, and philosophy. New York: Transaction Publishers.
LaBerge, S., Kahan, T. & Levitan, L. (1995). Cognition in dreaming and waking. Sleep Research, 24A, 239
Ortmann, A., and R. Hertwig, 2002: “The Costs of Deception: Evidence from Psychology”; Experimental Economics, 5: 111-132.
Suite, D. H., et al (2007, August).Beyond misdiagnosis, misunderstanding and mistrust: Relevance of the historical perspective in the medical and mental health treatment of people of color. Journal of the National Medical Association, 99(8), 879.
The video is an outstanding illustrator of the theoretical elements, such as self-awareness and limitations. The existential approach is based on a philosophy, which focuses on: “self-awareness, facing the unavoidable conditions of human existence, and authentic living” (Sommers-Flanagan & Sommers-Flanagan, 2018, p. 89). In other words, the process allowed the client to realize that her life was built on deliberate choices, which are symbiotic and interconnected. The client wants to go to school and leave her job because the former makes her feel delighted, and the latter does not appear appealing (“Video 4.1 Existential therapy,” n.d.). The concepts of self-awareness and authentic living are invoked in order to let her reflect on their interconnectedness.
There is a wide range of techniques utilized in the video, but they are centered around the notion of empathetic mirroring and self-reflection. The therapist was not a merely supportive individual but rather provided both feedback and confrontation with the client in regard to her challenges and difficulties in life. Initially, the technique involved the process of identifying the client’s issues and her own attitude towards them. Later, the therapist was utilizing confrontation measures, where she was partially disagreeing with her client because her main goal was to develop an “I-Thou Relationship.” One should be aware that “I-Thou Relationship” is a highly challenging task to do because it “involves the deepest of all possible connections … legitimate I-Thou moments are rare and brief” (Sommers-Flanagan & Sommers-Flanagan, 2018, p. 96). In other words, there is a specific goal of a session, where a client needs to build a differential perspective.
The therapist’s role in the video was based on identifying the problems, making them vocal, and observing whether they are existentially plausible. She actively seeks to make the client specific about her discontent with her life, which she claims to be her work. The therapist also demands that the client would define her emotions and feelings in regards to her school and work. At the end of the session, the therapist sums up the key milestones of the client’s life and how they fit together, which does her work appear as a part of her authentic living. Therefore, the role of a therapist is to let the clients identify the issue of their own and help them change their perspective on their lives.
The apparent treatment plan will involve two major parts, where a client asked several questions, which would help to identify the underlying problems. The questions need to be neutral or supportive, which means they should not be judgmental or disconnected from each other. The second part revolves around making sure that the issue is identified as an unalterable existential problem, where the therapist gradually allows a client to change his or her perspective on his or her life.
In my own practice, the concept that would work best is a realization of unavoidable conditions of human existence and authentic living. Therefore, my therapist technique would focus on life embracement and mirroring, where I will allow my clients to realize that their problems are existential limitations and that they will have a good life if they change their perspective through embracement. The goal will be based on ensuring that clients will focus on the state of their lives with consideration for existential limitations. The approach will include “I-Thou Relationship,” where clients form deep connections with other individuals or aspects of their lives.
References
Sommers-Flanagan, J. & Sommers-Flanagan, R. (2018). Counseling and psychotherapy theories in context and practice: Skills, strategies, and techniques (3rd ed.). John Wiley and Sons.
Counseling is a kind of psychological assistance aimed to overcome the problems of a mental and emotional nature.
There are four main theoretical frameworks of psychotherapy in which specific methods and techniques are used: psychodynamic, existential-humanistic, cognitive-behavioral, and postmodern.
Each of the directions is based on specific personality theories, and there is a logically connected system of psychotherapeutic influences. Despite the common goal, different types of consultations need to be applied to patients depending on the features of their character and the effectiveness in solving the particular problem.
Psychodynamic framework
The term “psychodynamic” or “dynamic” involves the consideration of a person’s mental life in terms of constant dynamics, movement, struggle, conflicts in the psyche, and their influence on the individual.
Models of Human Mind:
Topographical model:
Conscious;
Pre-conscious;
Unconscious.
Structural model:
Id;
Ego;
Superego.
Psychodynamic therapy is aimed at the cause of the disease condition, in most cases – neurotic conflict. Its resolution marks the reunification of the unconscious part of the psyche with conscious processes.
The psychodynamic direction comes from old and famous psychoanalysis, the founder of which is Sigmund Freud (Holden, Fall, and Marquis 2017). For psychodynamic direction, it is fundamental that thoughts, feelings, and behavior are deterministic by unconscious mental processes. There are many different schools within the dynamic framework, but perceptions of unconscious mental processes and psychotherapeutic methods are common to members of this approach. The basic concepts studied within the framework of psychoanalysis are the structure of the person’s personality, the stages of personal development, the mechanisms of psychological protection.
According to classical psychoanalysis, there are topographical and structural models of the human psyche (Holden, Fall, and Marquis 2017). For the topographical model, the mind consists of such components:
conscious – something that person currently realize – is the smallest part of a person’s psyche;
pre-conscious is something that a person did not currently realize, but it can easily do it;
unconscious – something that person did not realize – is the most significant part of a person’s psyche.
The unconscious includes primitive instincts, emotions, and memories that are so traumatic to consciousness that they are pushed into the unconscious. For example, child trauma, suppressed sexual desires, hidden hostile feelings towards parents, and others. These unconscious experiences find no way out in ordinary life but manifest themselves in painful symptoms symbolizing the problem (Holden, Fall, and Marquis 2017). The purpose of psychotherapy is primarily their awareness and elaboration.
The structural model of psyche also implies the existence of three main components:
“ID” is an unconscious structure, which includes innate instincts – the oldest and most stable structure of the mind.
“Ego” is a conscious structure, a reasonable, rational part of a person. It seeks to fulfill the wishes of “id” following the restrictions adopted in the real world.
“Superego” is a conscious structure that counteracts and seeks to suppress “id.” It is a unique version of social norms and standards of behavior accepted by an individual. “Superego” develops in the process of upbringing, includes all those values that are formed following social norms. Moreover, it implies a strict system of restrictions, prohibitions, standards.
Existential-humanistic framework
Existential-humanistic psychology views personality as a unique, holistic system, that is impossible to understand through individual manifestations and components.
The basic principles of humanistic psychology are: recognition of the holistic nature of human nature, openness to new experience, freedom of will, spontaneity and creative capabilities of man, ability to grow.
The humanist approach does not view anxiety as a negative factor. From this position, stress is constructive, contributing to personal change and development.
This direction is based on the philosophy of European existentialism and the phenomenological approach (Jones-Smith 2019). The main motives driving personal development are the realization of individual capabilities, the desire for self-realization and growth, self-expression, and others. It is happening through the achievement of life goals, and the disclosure of the meaning of their own existence.
Cognitive-behavioral framework
The cognitive-behavioral approach is focused on changing beliefs, attitudes, thinking patterns, and behaviors.
The theoretical basis of cognitive-behavioral psychotherapy is behaviorism. It is based on the position that science should describe only the phenomena available to direct observation, that is, behavior (Ginter, Gerstein, and Roysircar 2018).
Non-adaptive thinking → Misinterpretation and maladjustment → Disorders
Behavior is a set of reactions of the body to the effects of the external environment, to the particular stimulus. The person is considered as a carrier of certain forms of behavior.
In this direction, professionals are using the principles of teaching. Cognitive-behavioral psychotherapy includes a wide range of methods – cognitive, behavioral, rational psychotherapy, neurolinguistic programming and many others.
In terms of therapy in this direction, non-adaptive thinking is the main reason for psychogenic disorders (Ginter, Gerstein, and Roysircar 2018). Personality is shaping by cognitive structures, which are basal, often unconscious, beliefs (concepts about self, surroundings, and others). Thanks to such expectations, people selectively perceive and assess what is happening. It can lead to misinterpretation and subsequent maladjustment, which will enhance primary belief, by the principle of pathological feedback. Therefore, patient’s problems are in the present, in the real ways of thinking, but not in the past. Thus, the goals of cognitive-behavioral therapy are: correcting the erroneous processing of information and helping patients modify beliefs that support non-adaptive behavior and emotional response.
Postmodern framework
Postmodernists question all theories and assumptions of those frameworks, as they are sure it is impossible to give full answers to all questions (Jones-Smith 2019). Moreover, postmodern counsels move away from the classical focus on the individual and his inner world and view the person as an object formed by a specific environment.
The postmodern approach is significantly different from all previously mentioned. Since postmodernists are skeptical of therapy theories, they do not try to act as authorities during counseling. Instead, they are looking for ways to help without offering specific advice. Thus, this approach favors the use of many different methodologies instead of one.
Psychodynamic Theories
Theory of Object Relations:
Events of early childhood are tightly woven into the unconscious part of the person’s brain and manifest in social interaction in future adult life.
Self Psychology:
In a healthy atmosphere, children develop empathy abilities, as well as self-regulation and self-confidence patterns that will be inherent in adulthood.
Basing on the theory of object relations, the individual’s character and behavior can be explained by the experience he/she gained as a child. For example, if parents behave patiently and warmly with a child, he/she will also treat the world in this way. In the different situation, if parents are cruel – the same will be with the child in adult life.
Within Self Psychology, childhood also plays a main role in the personal development. At the beginning of their life, children will rely on self-objects to help meet needs. However, in the future, such external objects should not be needed under the condition of normally formed regulation and self-confidence patterns.
Psychodynamic Counseling Methods
Free associations. In the process of psychotherapy, the patient lies on the couch, closing his/her eyes, freely associates. It entail other assosiations that lie more deeply in the unconscious. Doctors interpret received associations, pushing the patient to realize the problem.
Dream analysis. According to the psychoanalytic concept of dreams, they are an attempt to discharge the emotional pressure accumulated during the day. The main task in the study of dreams is to achieve their hidden meaning.
The primary method in dream analysis is again free associations. When working with a patient, it is necessary not to pay attention to the external content of dreams, as it does not correspond in any way to the unconscious studied. Dreams should be broken down into elements, each of which is examined separately.
Existential-humanistic theories and concepts
Self-actualization is a process of revealing and implementation all person’s abilities and capabilities.
Gestalt psychology
The human aspires to integrity – perceives the environment not as a set of sensations, but as holistic images. Perception is shaping to focus primarily on the most urgent need.
Reason of mental disorders: the mismatch between a person’s desires and real life.
Existential-humanistic methods
The empty chair
An empty chair is placing opposite the chair where the patient sits. He or she is playing a role – talk to an important person as if this man was sitting on an empty chair.
“Here-and-now”
One of the main principles in gestalt therapy is the idea of “here-and-now,” – concentration on the present time. The therapist often asks the patient to determine what he/she currently thinks or feels, what is happening to the person at the moment.
Cognitive-behavioral approaches
Rational emotional behavior therapy or brief REBT is a type of psychotherapy during which patients detect thoughts, feelings that harm their mental health.
Dialectical behavior therapy or DBT is designed to treat multiple disorders or a problem that cannot be treated by other methods.
Then the task of rational emotional behavior therapy is to persuade the patient in the irrationality of negative opinions (Holden, Fall, and Marquis 2017). Afterward, the doctor helps replace them with more positive ideas that have a good impact on health.
There are versions of DBT applicable in a variety of care formats, including outpatient and inpatient care, group and individual therapy. It is used in the treatment of a tendency to suicide, deep depression or borderline personality disorder (Ginter, Gerstein, and Roysircar 2018). One of the goals of such therapy is to balance the patient’s acceptance of self and help him/her achieve change.
Cognitive-behavioral techniques
Mindfulness – a method is to free patients from the tendency to automatically react negatively to thoughts, emotions, events of life.
Journal writing therapy – the person focus on the main, fights with the complexes, remove stress.
One of the main techniques when applying cognitive-behavioral therapy is mindfulness. By practicing mindfulness, patients try to realize their psychological and physical condition without prejudice.
Another method doctors use within this approach is journal writing therapy. Describing the event, the person contemplates it, learns to focus on the main, fights with the complexes. Moreover, journaling helps to remove stress, which is often the cause of many serious diseases.
Postmodern approach
During counseling, the doctor helps draw up some narrative structure based on the individual patient’s experience (Jones-Smith 2019). It is the basis of treatment, during which the patient can consider his/her experience from the other side and, directed by the advisor, will learn to manage personal life.
Since the Postmodern calls into question the universality of understanding the person’s mental state and is skeptical of therapeutic theories, a different approach to clients has been developed here.
Postmodern techniques
During narrative therapy the counselor teaches people that they know their lives better than anyone else and only direct them.
Solution-Focused therapy is based on search and creating solutions rather than analyzing and finding the causes of problems.
Narrative therapy is a type of psychotherapy that comes from a respectful perspective that does not blame or impose on a person (Jones-Smith 2019). The person who seeks help is not patient or client, as in other therapeutic approaches, but a co-author of the therapy.
During Solution-Focused therapy the main attention is on decisions, hopes, resources, and strengths. To solve the problem, it is not necessary to spend a long time studying the reasons of its occurrence. This type of therapy is practical, useful, and offers hope for change, regardless of the degree of difficulty or expression of problems.
Conclusion
Psychotherapy is developing intensively, finding new and new applications – both in medicine and beyond. Counseling addresses a wide range of challenges, from simply eliminating symptoms and improving quality of life to profound personal changes.
The fact of the ever-increasing need in the therapy of millions of people is undeniable. The reason for this is the modern pace of life when people are increasingly prone to stress, closure, and loneliness. However, the awareness and expression of one’s own feelings and related needs, with the support of a psychotherapist, gradually change the client’s subjective reality.
Counseling is necessary in the contemporary world and will develop, considering various world trends.
References
Ginter, Dr. Earl J., Lawrence H. Gerstein, and Gargi Roysircar. 2018. Theories and Applications of Counseling and Psychotherapy: Relevance Across Cultures and Settings. Newbury Park: SAGE Publications.
Holden, Janice Miner., Kevin A. Fall, and Andre Marquis. 2017. Theoretical Models of Counseling and Psychotherapy. 3rd ed. London: Taylor & Francis.
Jones-Smith, Dr. Elsie. 2019. Theories of Counseling and Psychotherapy: An Integrative Approach. Newbury Park: SAGE Publications.
“Children in psychodynamic psychotherapy: Changes in global functioning” is a study that was conducted by Fredrik Odhammar, Eva C. Sundin, Mattias Jonson, and Gunnar Carlberg as part of Erica Process and Outcome Study on children. The study was carried out with the aim of establishing the effectiveness of the participants’ global functioning following psychodynamic psychotherapy. The participants involved children who had undergone psychodynamic psychotherapy. The work of Odhammar and the other researchers will be appraised in this critique, with particular emphasis on the research topic, the theoretical coherence, and logical structure, and the research design used. Also, the major findings of the study, their validity and reliability, and their practical implications to clinical practice will be examined.
Brief Summary
Odhammar and other researchers carried out their study as part of the Erica Process and Outcome Study. This is a study that investigated children’s global functioning following psychodynamic psychotherapy with the main focus being to establish whether global functioning is enhanced after treatment. The researchers assessed the factors that are thought to influence global functioning, such as age, sex, type of disorder, and co-morbidities among others using quantitative and statistical methods. The participants in the study included 33 children between the ages of 5 and 10 years who had been involved in psychodynamic psychotherapy at the same time with their parents. Twenty-nine (29) of the study participants were diagnosed with some mental health disorders, whereas fifteen (15) of the participants were diagnosed with co-morbid conditions. The diagnoses were based on the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV).
The psychotherapists used CGAS and HCAM tools to measure the participants’ global functioning. From the study, the researchers showed that psychodynamic psychotherapy significantly enhanced the children’s global functioning, even though the study did not establish any significant relationship in regard to factors like age and sex that are thought to influence global functioning. The researchers also sought to disambiguate the complex relationship existing between the psychodynamic psychotherapy procedure and the enhancement in global functioning. The researchers, thus, incorporated a qualitative study approach whereby in-depth case studies were performed using data generated from questionnaires that were obtained from two therapies and filled at intervals of 3 months. The researchers sampled two such therapies, including one that reported great improvement and one that reported minimal improvement in global functioning as measured under CGAS. On evaluation, the researchers established that significant changes, such as the achievement of set goals, in the patients were not regularly captured in the measurements on the CGAS (Odhammar et al. 2011).
Theoretical approaches and evaluation of the study by Odhammar et al. (2011)
To justify the need for their study, Odhammar et al. (2011) researched extensively about psychodynamic psychotherapy through broad literature review. The intense research on available relevant literature was important in improving the study’s reliability and validity, in addition to bringing out the research topic clearly (Riegelman, 2005). The researchers, therefore, started by illustrating the magnitude of psychological conditions among young people and the increasing range of psychotherapies and other interventions for children with these mental disorders. From the literature review, the researchers demonstrated that the increasing incidents of mental disorders in young people require the mental health sectors to avail knowledge concerning variables that influence therapy outcomes.
Odhammar et al. (2011) highlight the increasing number of studies that have been carried out in response to the need to identify the variables that affect psychotherapeutic outcomes in young people. According to Odhammar et al. (2011), a dominant feature of these studies is that the findings are not consistent. This makes it hard for inferences to be done. The researchers in particular highlighted studies that have been conducted to establish the effects of gender on child psychotherapy, whereby some findings indicated that females showed improved outcomes than males the following psychotherapy. Other studies on the same demonstrated no significant differences based on gender. Similarly, Odhammar et al. (2011) explored literature that investigated the impact of gender on psychotherapy outcomes. The researchers also found discrepancies in the findings, with some studies showing that younger children responded much better to psychotherapy compared to those who are much older. Nevertheless, other studies have failed to establish a link between a person’s age and the treatment outcomes (Odhammar et al., 2011).
The researchers further explored the reviews that have been carried out on psychotherapy studies, indicating the various beliefs as embraced by different people concerning cognitive behavioral therapy. From the analyses, it comes out that some people advocate for systemic therapy evaluations, whereas others are for psychodynamic time-limited therapies. With regard to psychodynamic psychotherapy, which was the core aspect of the study, the researchers also further analyzed literature reporting on how other conditions influence treatment outcomes. From these analyses, the researchers demonstrated that the existing information is also conflicting concerning the duration of psychodynamic psychotherapy. Whereas some studies showed that time-limited interventions produced desirable outcomes, other studies indicate that therapy outcome is positively associated with the duration taken to carry out the procedure.
The researchers indicate the need for further studies that can be able to address the observed shortcomings. These studies ought to be more detailed and adequately explore factors that influence effective therapeutic outcomes. This, according to the researchers, demands a comprehensive understanding of the treatment process and comprehending any other variables such as those related to the therapeutic procedure, individual patient, therapist, and the formation of a therapeutic alliance. These are variables that underlie change factors with respect to treatment outcome. In reinforcing their research topic, Odhammar et al. (2011) also point to the challenges involved in quantifying outcome aspects like quality of life, in addition to the failure of efficacy studies to represent real practical settings. This calls for the need for naturalistic studies.
The motivation for the Study
Odhammar et al. (2011) were motivated by the recognition that psychological problems are on the rise among children, yet research on this field fails to adequately address the variables that influence psychotherapy outcomes. The contradictions in research findings on child psychotherapy from various studies also motivated the researchers to conduct the study. Odhammar and the other researchers hoped to advance knowledge concerning the variables that influence psychotherapy treatment outcomes in children through this study, thereby allowing for effective interpretation.
Research Questions
Odhammer et al. (2011) formulated research questions to address different aspects of psychodynamic psychotherapy in children. The main area was assessing changes in global functioning in young people following psychodynamic psychotherapy. Another aspect of the research questions was establishing variables that influence the likely changes in global functioning following therapy, while the last part of the research questions aimed at qualitatively analyzing the deviations of the outcomes by evaluating processes of therapy.
Research Design
The study by Odhammer et al. (2011) was naturalistic in design, combining both quantitative and qualitative techniques to assess global functioning following psychotherapy. This design allowed the subjects to be observed in the natural settings, thus allowing the description of outcomes to be performed without controlling the situation. The design was also significant in examining the outcomes and drawing inferences since the variables could easily be conceptualized and operationalized. The quantitative technique involved the use of questionnaires that were administered to psychotherapists and parents of the participants, whereas the qualitative study was conducted through comprehensive case studies.
Study Findings
The study results demonstrated that global functioning in children improved significantly following psychodynamic psychotherapy, indicating the effectiveness of the treatment modality. In quantitative analyses, the factors that determine enhancement of global functioning under CGAS scale were shown to be, “age, sex, diagnosis, co-morbidity, frequency and number of sessions, length in weeks of child therapy and a number of sessions for parents” (Odhammar et al. 2011, p. 267). These factors, however, showed no major relationship with the change scores. Under the HCAM measurement, global functioning was also shown to be large, especially with regard to “general mood and mood shifts, ability to tolerate frustration and control impulses, development of confidence and self-esteem and ability to cope with very stressful events” (Odhammar et al. 2011, p. 267). Qualitative analyses showed that significant enhancements obtained following treatment are frequently missed in psychometric tools, thus they are often not considered as important outcome factors following treatment.
Limitations of the Study
The findings of the study may not be readily generalized to the entire population given that the participants were mainly included in the study using clinical criteria. In addition, the study did not include a comparison group in order to obtain a deep comprehension of the level of a desirable outcome. The fact that it is psychotherapists who were measuring the global functioning of the participants also implies that the results may be biased. Additionally, the number of participants was small. This would have affected the validity, reliability and the ability to generalize of the study findings (Odhammar et al., 2011).
Clinical Implications of the study
The study was significant in clinical practice given that it helped in closing the knowledge gap concerning the effect of psychodynamic psychotherapy in global functioning. The research further highlighted the effect of various factors, such as age and gender, on global functioning; besides giving insights on the way the treatment modality influences outcomes. The study, therefore, contributes to knowledge regarding factors that influence psychodynamic child psychotherapy outcomes, the knowledge that will be critical in the management and treatment of psychological disorders in young people.
Reliability and Validity of the Study
The use of a small population in the study enhanced transferability of the results since the researchers were able to obtain a natural and interpretative understanding of the variables that affect psychotherapy outcomes. Nevertheless, the small number of participants means that the findings cannot be readily generalized to the entire population. It will, therefore, be important for future research on the same area to include a large population in order to improve the ability to generalize the findings. The use of both qualitative and quantitative methods enhanced the reliability of the study findings since the researchers were able to combine the strengths of the two methods (Riegelman, 2005). The methods also facilitated the interpretation of the study findings since the data generated provided deep insights on various aspects of the study topic. The study can also be said to have achieved high credibility given the diverse amount of literature that was reviewed.
References
Odhammar, F., Sundin, E. C., Jonson, M., & Carlberg, G. (2011). Children in psychodynamic psychotherapy: changes in global functioning. Journal of child Psychotherapy, 37(3), 261-279. Web.
Riegelman, R. K. (2005). Studying a study and testing a test: How to read the medical evidence, 5th Ed. Philadelphia, PA: Lippincott Williams & Wilkins. Web.
There are different forms of therapy, and it is vital for psychiatric mental health nurse practitioners (PMHNPs) to know and distinguish it. Supportive and Interpersonal types of treatment share similar patterns and differ from each other in some ways. PMHNPs can decide what form of therapy is the most favorable for a client. In the current assignment, the primary aim is to address similarities of supportive and interpersonal psychotherapies and to discuss three differences between them. Moreover, the impact on practice depending on a form of therapy, is presented and discussed. In conclusion, a suitable personal approach with clients is mentioned and explained.
Similarities
Both forms, Supportive and Interpersonal psychotherapy, pay special attention to a therapeutic approach to clients that diagnosed with mental health diseases. The practices aim at dealing with severe psychological issues such as anxiety and depression. The two therapeutic forms concentrate on personality problems, simultaneously reducing current symptoms (Wheeler, 2014). Thus, Supportive and Interpersonal psychotherapy share a similar approach to treatment.
Differences
One of the significant differences is that Supportive psychotherapy does not need as in-depth professional training as Interpersonal, where future specialists learn to work with clients diagnosed with interpersonal disputes, grief, role transitions, and other relationship issues (Wheeler, 2014). Supportive therapy is the form of treatment chosen by a client to treat negative symptoms and improve self-esteem and mental state (Winston & Lujack, 2015). To do so, this form of psychotherapy involves numerous strategies, including working on cognitive, defensive, and interpersonal problems (Wheeler, 2014). According to Cuijpers et al. (2016), Interpersonal psychotherapy is efficient in reducing depressive symptoms and preventing relapse. At the same time, the form of therapy is proven to be useful in treating eating disorders.
Impact on Practice
Supportive psychotherapy is found to be efficient in working with psychotic disorders. As Wheeler (2014) states in his book, “the left-brain frontal cortex problem-solving abilities are greatly impaired” (p. 239). In this case, Supportive therapy can be especially helpful for psyche stabilization. Concerning Interpersonal therapy, it is more useful for treating problems gained in the past, as it is concerned with interpersonal interactions (Wheeler, 2014).
Supportive Psychotherapy Approach
Supportive psychotherapy is a form that was chosen as my approach to clients. Nevertheless, it should be highlighted that every case is unique. The above mentioned form is proven to be the most common in most situations (Winston & Lujack, 2015). The method is widely used in doctor-patient communication and applied to clients diagnosed with mental illnesses (Rothe, 2017). In my personal opinion, Supportive psychotherapy will be the most beneficial in supporting mental well-being, as well as finding solutions for increasing self-esteem and raising self-awareness.
Conclusion
It should be noted that it is vital for PMHNPs to work with mental illnesses to distinguish and understand different kinds of therapy. For this reason, the current paper presented similarities and differences between Supportive and Interpersonal approaches. Each form can be beneficial for some cases, while detrimental for others. It appears to be essential to choose the best form of therapy to treat the client efficiently.
Wheeler, K. (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (2nd ed.). Springer Publishing Company.